NALOXONE PRICING IN THE COMMUNITY (As of January 2019)
`naloxone
`naloxone
`injection
`prefilled
`(0.4mg/mL)
`syringe
`(2 mg/2 mL)
`
`Narcan® nasal
`spray
`(4 mg/0.1 mL)
`
`Evzio® auto-
`injector
`(2 mg/0.4 mL)
`
`Route of medication
`
`Cash Price based on
`goodrx.com1
`
`Intramuscular
`only
`
`Intranasal
`with atomizer
`
`$12.80 to
`$21.13*
`
`$20.99 to
`$36.85
`
`Intranasal
`$129.99 to
`$139.13
`
`$18.99
`
`NA
`$3.65†
`
`$38.99
`
`$39.99
`$3.65†
`
`$953
`
`$135
`$3.65†
`
`Tier 1 or Tier 2 Tier 1 or Tier 2
`
`Tier 3 or Tier 4
`
`Tier 1
`
`Tier 1
`
`Tier 4
`
`50%
`coinsurance‡
`
`Generic
`
`CVS Pharmacy2
`
`Walgreens4
`
`MassHealth
`Fallon
`Community
`Health Plan
`
`AllWays
`Health
`Partners §
`Tufts
`
`Commercial
`3-Tier or 4-
`tier
`Formulary
`
`Hybrid
`Formulary
`
`NaviCare
`(Medicare
`Part D)
`3 Tier, 4 Tier,
`5 Tier, 6 Tier
`Formulary
`Health
`RITogether
`
`$1
`Generic
`available
`through mail-
`order
`
`Tier 1 or Tier 2
`
`Tier 1
`
`$1
`Generic
`available
`through mail-
`order
`
`$0
`
`NA
`
`NA
`
`Health Direct
`
`$0
`
`Intramuscular
`
`>$3,720
`
`$2,225.99
`
`NA
`NA
`
`Tier 3 or Tier 4;
`PA
`
`Tier 3; PA
`
`$30
`
`NA
`
`Tier 2 or Tier 3
`
`NA
`
`Tier 2; QL: 2
`kits/30 days, 1
`kit/Rx
`
`$0
`
`Tier 2; QL: 4
`units/30 days,
`2 units/Rx; PA
`Tier 3; QL: 4
`units/30 days,
`2 units/Rx; PA
`
`Blue Cross
`Blue Shield of
`MA Standard
`
`Tier 1
`
`Tier 3
`
`Tier 3
`
`Tier 2
`
`Not covered
`
`Standard 3-
`Tier
`Pharmacy
`Program
`Formulary
`3-Tier
`Harvard
`$0; QL: 2
`$0; QL: 2
`$0; QL: 2
`Prescription
`Pilgrim Health
`bottles/15 days
`mL/15 days
`ml/15 days
`Drug Plan
`Care
`IM=intramuscular, IN=intranasal, IV=intravenous, NA=not available, PA=prior authorization, QL=quantity limit, RX=prescription
`*Price per mL
`†MassHealth copayment
`‡$400 maximum
`§ Formerly Neighborhood Health Plan
`1. https://www.goodrx.com/
`2. CVS Source: 1163 Providence Road, Whitinsville, MA 
`3. https://cvshealth.com/newsroom/press-releases/cvs-health-expands-efforts-educate-patients-about-naloxone
`4. Walgreens Source: 99 Stafford Street, Worcester, MA 
`
`Opiant Exhibit 2118
`Nalox-1 Pharmaceuticals, LLC v. Opiant Pharmaceuticals, Inc.
`IPR2019-00685
`Page 1
`
`

`

`
`
`Intranasal administration
`Naloxone 4 mg/0.1 mL nasal spray*
`
`
`Directions for use: Administer a single spray of
`naloxone in one nostril. Repeat after 3 minutes if
`no or
`minimal response.
`Naloxone 2 mg/2 mL single-dose Leur jet prefilled
`syringe*†
`
`Directions for use: Spray 1 mL in each nostril.
`Repeat after 3 minutes if no or minimal response.
`
`Intramuscular injection
`Naloxone 0.4 mg/mL in 1 mL single dose vials*
`
`Directions for use: Inject 1 mL IM in shoulder or
`thigh. Repeat after 3 minutes if no or minimal
`response.
`
`Naloxone 2 mg/0.4 mL auto-injector*
`
`
`Directions for use: Follow audio instructions from
`device. Place on thigh and inject 0.4 mL.
`Repeat after 3 minutes if no or minimal response.
`
`Naloxone Standing Order:
` Naloxone is available in Massachusetts without a prescription through a statewide standing order.
` https://www.mass.gov/files/documents/2018/10/18/standing-order-dispensing-naloxone-rescue-
`kits.pdf
`
`*Dispense two doses
`† Atomizer dispensed separately
`
`Other resources related to naloxone procurement:
` Massachusetts Department of Public Health (DPH) Overdose Education and Naloxone
`Distribution (OEND)
`https://www.mass.gov/service-details/information-for-community-members-about-how-to-get-
`naloxone
` AIDS Project Worcester provides free Narcan and Narcan training on a scheduled or walk-in
`basis through the Joe McKee Care Center. https://www.aidsprojectworcester.org/narcan/
` Evzio Patient Assistance Program:
`https://evzio.com/patient/in-chronic-pain/kaleo-cares/
` US citizens without insurance (commercial, state, or federal) and an annual household
`income <$100,000
`
`  
` 
`
` 
`
`Opiant Exhibit 2118
`Nalox-1 Pharmaceuticals, LLC v. Opiant Pharmaceuticals, Inc.
`IPR2019-00685
`Page 2
`
`